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Clinical Review Specialist
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Job Description
- Req#: RQ4024123
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work remotely from anywhere within the United States
- Collaborative work environment that fosters relationships across the enterprise
- Chance to make a positive impact on patient care through accurate medical documentation
- Maintain professional competency with ongoing education and training opportunities
What to Expect (Job Responsibilities):
- Perform accurate pre-visit reviews of ambulatory encounters to identify opportunities for medical condition recapture
- Interpret clinical information in medical records to evaluate potential diagnoses
- Educate providers on diagnostic specificity to accurately reflect patient conditions
- Identify education and process improvement opportunities through chart reviews
- Communicate effectively with care teams to enhance medical record documentation
What is Required (Qualifications):
- Minimum three (3) to five (5) years of experience in case management, outpatient coding, utilization review, or Clinical Documentation Improvement (CDI)
- 2 years of experience in Primary Care, medical coding, risk adjustment, or CDI preferred
- Current certification in Clinical Documentation Improvement (CDIP, CCDS, CCDS-O, or CDEO) preferred
- Certification in medical coding and/or risk adjustment (e.g., CRC, CPC, CCS, CDEO) preferred
- Strong PC skills, including proficiency in Microsoft applications such as Outlook, Teams, Excel, and PowerPoint
How to Stand Out (Preferred Qualifications):
- Medical licensure (RN, PA, NP) preferred
- Bachelor's degree in a healthcare-related field preferred
- Experience with risk adjustment or CDI concepts
- Familiarity with Epic resources for medical record documentation
- Commitment to maintaining clinical licensure and/or coding credentials
#HealthcareServices #RemoteWork #CareerOpportunity #PatientCare #MedicalDocumentation
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